Rawan Yaghi, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12078 Issued in MN

Practice address

195 Jefferson Blvd
Big Lake, MN 55309-9572

Phone

(763) 263-2222

Fax

(763) 263-5822

NPI assigned

Oct 2, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dental Services Inc

  dba The Smile Center

  • General Practice Dentistry
  • Big Lake, MN
  • NPI 1013069012
  NPD (past)
• Modern Dental Professionals MN PC

  dba Midwest Dental

  • General Practice Dentistry
  • Big Lake, MN
  • NPI 1215307061
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191283200000",
    "number": "1255528402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 JEFFERSON BLVD",
            "city": "BIG LAKE",
            "state": "MN",
            "postal_code": "553099572",
            "telephone_number": "763-263-2222",
            "fax_number": "763-263-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 JEFFERSON BLVD",
            "city": "BIG LAKE",
            "state": "MN",
            "postal_code": "553099572",
            "telephone_number": "763-263-2222",
            "fax_number": "763-263-5822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAGHI",
        "first_name": "RAWAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-02",
        "last_updated": "2007-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "D12078",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert D Wark, MA LMFT
• Stephanie Ruth Warwas, LICSW
• Glenn W Weidenbacher, MD
• Sara Jean Winkelman, M.S. CCC-SLP
• Kimberly Ann Wojack, R.D.H.

• General Practice Dentistry in Big Lake, MN
• Providers in Big Lake, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.